Background: Radiological response assessment is becoming challenging with novel immune-based combinations for metastatic renal cell carcinoma (mRCC). RECIST criteria appear not exhaustively adequate to capture the kinetics of treatment response, which is better reflected by tumor growth rate (TGR). We explored TGR changes during first-line treatments and its association with clinical outcomes in mRCC. Research design and methods: We retrospectively evaluated TGR in untreated patients undergoing pembrolizumab/axitinib (P/A) or tyrosine-kinase inhibitors (TKI). TGR was calculated at the first (TGR1, after 3 months) and the second (TGR2, after 6 months) evaluation, thus assessing the TGR2-TGR1 difference. Results: Thirty-three patients were included (P/A n = 15, TKIs n = 18). Volumes firstly decreased more rapidly with TKIs, and then more slowly. Volumes initially remained stable with P/A, quickly decreasing until the second evaluation. TGR1 was related to progression-free survival (PFS; p = 0.023) and overall survival (p = 0.046) with P/A. TGR2 was correlated with PFS in all patients (p = 0.025). Patients with higher velocity volume reduction appeared to have improved survival benefits than patients with lower velocity considering both treatments, but especially with P/A. Conclusion: Combining immunotherapy with TKIs has an important role in enhancing the rapidity of tumor shrinkage. A rapid disease volume reduction correlates with better OS and PFS.

Tumor growth rate to assess therapy response to immune-based combinations for metastatic renal cell carcinoma / Mollica, Veronica; Rosellini, Matteo; Brocchi, Stefano; Galuppi, Francesco; Paccapelo, Alexandro; Tateo, Valentina; Marchetti, Andrea; Tassinari, Elisa; Mantuano, Francesco; Santoni, Matteo; Massari, Francesco. - In: EXPERT REVIEW OF PRECISION MEDICINE AND DRUG DEVELOPMENT. - ISSN 2380-8993. - ELETTRONICO. - 9:1(2024), pp. 17-24. [10.1080/23808993.2024.2330422]

Tumor growth rate to assess therapy response to immune-based combinations for metastatic renal cell carcinoma

Mollica, Veronica
Primo
;
Rosellini, Matteo;Brocchi, Stefano;Galuppi, Francesco;Paccapelo, Alexandro;Tateo, Valentina;Marchetti, Andrea;Tassinari, Elisa;Mantuano, Francesco;Massari, Francesco
Ultimo
2024

Abstract

Background: Radiological response assessment is becoming challenging with novel immune-based combinations for metastatic renal cell carcinoma (mRCC). RECIST criteria appear not exhaustively adequate to capture the kinetics of treatment response, which is better reflected by tumor growth rate (TGR). We explored TGR changes during first-line treatments and its association with clinical outcomes in mRCC. Research design and methods: We retrospectively evaluated TGR in untreated patients undergoing pembrolizumab/axitinib (P/A) or tyrosine-kinase inhibitors (TKI). TGR was calculated at the first (TGR1, after 3 months) and the second (TGR2, after 6 months) evaluation, thus assessing the TGR2-TGR1 difference. Results: Thirty-three patients were included (P/A n = 15, TKIs n = 18). Volumes firstly decreased more rapidly with TKIs, and then more slowly. Volumes initially remained stable with P/A, quickly decreasing until the second evaluation. TGR1 was related to progression-free survival (PFS; p = 0.023) and overall survival (p = 0.046) with P/A. TGR2 was correlated with PFS in all patients (p = 0.025). Patients with higher velocity volume reduction appeared to have improved survival benefits than patients with lower velocity considering both treatments, but especially with P/A. Conclusion: Combining immunotherapy with TKIs has an important role in enhancing the rapidity of tumor shrinkage. A rapid disease volume reduction correlates with better OS and PFS.
2024
Tumor growth rate to assess therapy response to immune-based combinations for metastatic renal cell carcinoma / Mollica, Veronica; Rosellini, Matteo; Brocchi, Stefano; Galuppi, Francesco; Paccapelo, Alexandro; Tateo, Valentina; Marchetti, Andrea; Tassinari, Elisa; Mantuano, Francesco; Santoni, Matteo; Massari, Francesco. - In: EXPERT REVIEW OF PRECISION MEDICINE AND DRUG DEVELOPMENT. - ISSN 2380-8993. - ELETTRONICO. - 9:1(2024), pp. 17-24. [10.1080/23808993.2024.2330422]
Mollica, Veronica; Rosellini, Matteo; Brocchi, Stefano; Galuppi, Francesco; Paccapelo, Alexandro; Tateo, Valentina; Marchetti, Andrea; Tassinari, Elisa; Mantuano, Francesco; Santoni, Matteo; Massari, Francesco
File in questo prodotto:
File Dimensione Formato  
ERPMDD 2024 [TGR].pdf

accesso aperto

Tipo: Versione (PDF) editoriale
Licenza: Licenza per Accesso Aperto. Creative Commons Attribuzione - Non commerciale (CCBYNC)
Dimensione 1.84 MB
Formato Adobe PDF
1.84 MB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/966519
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 0
  • ???jsp.display-item.citation.isi??? 0
social impact